The components of parenteral nutrition include adequate fluid (30-mL/kg body weight/24 h for adults, plus any abnormal loss); energy from glucose, amino acids, and lipid solutions; nutrients essential in severely ill pts, such as glutamine, nucleotides, and products of methionine metabolism; and electrolytes, vitamins, and minerals. The risks of parenteral therapy include mechanical complications from insertion of the infusion catheter, catheter sepsis, fluid overload, hyperglycemia, hypophosphatemia, hypokalemia, acid-base and electrolyte imbalance, cholestasis, metabolic bone disease, and micronutrient deficiencies.

The following parameters should be monitored in all pts receiving supplemental nutrition, whether enteral or parenteral:

• Fluid balance (weight, intake vs. output)
• Glucose, electrolytes, BUN (daily until stable, then 2× per week)
• Serum creatinine, albumin, phosphorus, calcium, magnesium, Hb/Hct, WBC (baseline, then 2× per week)
• International normalized ratio (INR) (baseline, then weekly)
• Micronutrient tests as indicated